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Nurse distinction in nsg homes..rn and lpn

Nurses   (1,795 Views 15 Comments)
by RNOTODAY RNOTODAY, BSN, RN (Member) Nurse

RNOTODAY has 18 years experience as a BSN, RN and specializes in NICU, ER, OR.

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How does it work in most LTC/nursing homes re: a RN and an LPN.

I mean, assignment wise, do they make a distinction between the two?

Like, do LPN's take charge and RN's take an assignment?

I am curious, because at the nsg home I take per diem shifts at, there is no distinction btwn the two. But I heard another Rn say its not like that elsewhere....and I am wondering how different it can be.

This is a new world to me, and I want to know if this place is good, or bad!!!

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It depends on the facility. I am an LPN and I work as night shift supervisor. I supervise RN's and LPN's. We have the same job description except my facility prefers RN's to do the blood draws, mix IV drugs that need to be mixed and LPN's cannot do IVP drugs. We do the same work, we just get paid about $4 less per hour thatn the RN's.

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

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Your designation is what your job title is. Both LPNs and RNs are charge nurses. Charge nurses whether they are LPNs or RNs are pretty much on equal footing when it comes to the job duties they have to perform. The differences will come in where it comes to their individual nursing practice. As I'm sure you are aware, there are some nursing procedures and delegation responsibilities that ONLY RNs can perform and this is laid out in each state's nursing laws. An LPN can indeed be a supervisor over an RN, but only in regard to the RN as an employee of the facility related to non-nursing parts of the job (things such as attendance and tardiness, behavior, following facility rules of conduct). An LPN cannot instruct or supervise the nursing practice of an RN (managing patient care, how specific nursing procedures are done). LTC is quite a unique place to work. I've worked in a lot of LTCs over the years shoulder to shoulder with fine LPNs who were charge nurses just as I was. I gave them every respect as charge nurses and leaders of their nursing teams.

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Depends on the facility AND the state.

The LPN scope of practice in NY is far more limited than that of, say, TX. I have never seen an RN supervised by an LPN here.

Some of our unit managers are LPNs and they're over some RNs that are hired as regular floor/charge nurses.

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MelodyRNurse has 3 years experience and specializes in ED, Rehab, LTC.

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In the facility I work in RN and LPNs are charge, but I don't think LPNs supervise.

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Some of our unit managers are LPNs and they're over some RNs that are hired as regular floor/charge nurses.

How long have the LPN's been doing that? And where are you?

It is changing here. Within the past two years a lot of stuff LPN's were doing in LTC has been taken away by DON's trying to bring their facilities more in line with the legal scopes of practice. Since LPN's can not assess it's impossible for one to truly be charge and they are slowly being replaced with RN's as positions (and RN's) become available.

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It depends on your Nurse Practice Act, not the facility. Read it. In Texas an RN must make the initial assessment, determine the plan of care (including what type of teaching should take place) and assign/delegate per NPA guidelines. LVN's can do followup evaluations and the actual teaching that was planned. There are other guidelines pertaining to each type nurse. In Texas ignorance of the NPA is no excuse for acting outside your scope of practice.

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kstec has 1 years experience as a LPN and specializes in Geriatrics/Family Practice.

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In the LTC facility that I work at LPN's and RN's are pretty much equal. The only difference is if we get a PICC line the RN has to maintain it, not the LPN and that is because of facility regs. Our DON is a RN and our ADON is a LPN. That is the main reason I like working LTC and at a clinic because there really isn't a who's better than who job title or treatment. We are all the same working toward the same common goal "Taking care of the patient". Oh and yes we all help (RN's and LPN's) clean do do and all the other stuff necessary to promote quality care with our residents. For RN's that want to be bosses you'd have to be a DON pretty much in order to manage everyone.

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How long have the LPN's been doing that? And where are you?

It is changing here. Within the past two years a lot of stuff LPN's were doing in LTC has been taken away by DON's trying to bring their facilities more in line with the legal scopes of practice. Since LPN's can not assess it's impossible for one to truly be charge and they are slowly being replaced with RN's as positions (and RN's) become available.

I really don't know how long they've been working there or as unit managers, but must be at least a few years. I live in Virginia, and my workplace is in Dublin. The unit managers consist of 4/5 LPNs and one RN.

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I really don't know how long they've been working there or as unit managers, but must be at least a few years. I live in Virginia, and my workplace is in Dublin. The unit managers consist of 4/5 LPNs and one RN.

Yeah, see the different states have different rules. New York is one of the most restrictive, as well as being THE most regulated.

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